Individual provider · NPI-1

Jay Joseph Allen, M.D.

Family Medicine · Duluth, MN

NPI number1891228094
StatusActive
Last updated in NPPESJul 3, 2020

Details

NPI
1891228094
Entity type
Individual (NPI-1)
Name
Jay Joseph Allen
Credential
M.D.
Sex
Male
Sole proprietor
No
Enumeration date
Apr 5, 2017
Certification date
Jul 3, 2020
Last updated
Jul 3, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine66743MNYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

1502 London Rd Ste 102
Duluth, MN 55812-1787

Phone 218-576-0100

Mailing address

1702 University Dr S
Fargo, ND 58103-4940

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